The Nuts Holder is a safe and feasible device that standardizes tissue fixation, prevents assistant-related instability, and successfully facilitates solo surgery in urology.
Abstract
NeedAdequate stabilization in scrotal and penile surgeries is essential but traditionally relies on manual fixation, causing assistant fatigue and operative instability.Technical SolutionWe developed the Nuts Holder, an adjustable, reusable stainless steel support device featuring a screw-and-slide mechanism designed to gently clamp and stabilize the target organ.Proof of ConceptIn 16 consecutive urological cases, including microTESE, the device was successfully applied without any complications. A surgeon survey demonstrated 100% agreement on improved operative stability, reduced assistant dependence, and enhanced maintenance of microscopic focus.Next StepsTo address an initial learning curve regarding setup ease, a second-generation model featuring a quick-release mechanism and reduced weight is currently under development.ConclusionThe Nuts Holder is a safe and feasible device that standardizes tissue fixation, prevents assistant-related instability, and successfully facilitates solo surgery in urology.
Three successful interventions show that involving surgeons in the design and testing phase of product development leads to a novel instrument positioner that can be used safely in a clinical setting and is simple and intuitive to use, as there was no learning curve.
The Zero-Touch Technique (ZTT) is introduced, a fundamentally new operative paradigm enabled by a purpose-designed sterile genital barrier system that completely isolates the penis and scrotum, allowing all subsequent steps to occur without contact with hair-bearing genital skin.
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